04-6013 (RC)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 . (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . . . 04-00006013 Date 2/01/05
Property Address . . . . . . 78370 HIGHWAY 111 STE 180
APN: 604-050-048- - -
Application description . . . REMODEL - COMMERCIAL
Property Zoning . . . . . . . COMMUNITY COMMERCIAL
Application valuation . . . . 50000
Owner
------------------------
MADISON PTM LA QUINTA
71361 SAN GORGONIO RD
RANCHO MIRAGE CA 92270
Contractor
-'------ - ----------------
PRIMUS CONTRACTING GROUP, INC
1409 SO. 600 WEST, SUITE D
BOUNTIFUL UT 84010
WCC: STATE FUND
WC: 17051812003
10/01/04
CSLB: 814726
11/30/04
CCC: B
------ Structure Information
COMMERCIAL REMODEL
-----
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . . .
. . . BUSINESS <50
Other struct info . .
. . . CODE EDITION 2001
FIRE SPRINKLERS YES
OCCUPANT LOAD
49.00
---------------------------------------------------_-------------------------
1ST FLOOR SQUARE FOOTAGE- 1474.00
Permit . . . . . .
BUILDING -PERMIT
Additional desc . .
Permit Fee . . . .
414.50 Plan Check Fee
269.43
Issue Date . . . .
9/15/04 Valuation . . . .
50000
Expiration Date
7/23/05
. Qty Unit Charge
Per
Extension
BASE FEE
252.00
25.00 6.5000
-------------------------------------------------------------------------=--
THOU BLDG 25,001-50,000
162.50
Permit . . . . . .
ELECT - ADD/ALT/REM
Additional desc . .
Permit Fee . . . .
44.48 Plan Check Fee
11.12
Issue Date . . . .
9/15/04 Valuation . . . .
0
Expiration Date . .
7/23/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1474.00 .0200
----------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
29.48
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee . . . .
39.50 Plan Check Fee
9.88
P.O. Box 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Date:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my License is in full force and effect.
License Class License No.
Date Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
U I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work
himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.).
U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. , BA P.C. for this reason
Date
Owner.
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My workers' compensation insurance carrier and policy number are:
Carrier Policy Number
I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date Applicant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnify and hold harmless the City of La Ouinta, its
officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
Date Signature (Applicant or Agent):
lJ
Page
2
Application Number .
. . . . 04-00006013 Date
2/01/05
Issue Date . . .
9/15/04
Valuation . . . .
0
Expiration Date . .
7/23/05
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 9.0000
EA MECH
FURNACE <=100K
9.00
1.00 9.0000
EA MECH
B/C <=3HP/100K BTU
9.00
1.00 6.5000
----------------------------------------------------------------------------
EA MECH
VENT FAN
6.50
Permit
PLUMBING
Additional desc .
Permit Fee . . . .
91.50
Plan Check Fee
22.88
Issue Date
9/15/04
Valuation
0
z Expiration Date
7/23/05
. . . .
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
11.00 6.0000
EA PLB FIXTURE
66.00
1.00 7.5000
EA PLB WATER HEATER/VENT
7.50
1.00 3.0000
----_------------------------------------------------------------------------
EA PLB WATER INST/ALT/REP
3.00
Special Notes and Comments
Commercial Remodel -
REA DAY SPA
Salon
TI, 1474 sqft, Type VN Sprinkled,
"B"
Occupancy, Occupant Load
49.
----------------------------------------------------------------------------
Other Fees . . . . .
. . ... STRONG MOTION (SMI) - COM
10.50
Fee summary Charged
-----------------
Paid Credited
Due
.----------
Permit Fee Total
----------
589.98
--------------------
589.98 .00
.00.
Plan Check Total
313.31
313.31 .00
.00
Other Fee Total.
10.50
10.50 .00
.00
Grand Total
913.79
913.79 .00
.00
lJ
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
January 31, 2005
To Whom It May Concern:
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
Please be advised of an address change for the following, structure. Effective
immediately, the structure formerly addressed as 78-380 Highway 111, APN:
604-050-048, Par 9, Parcel Map 197/028 PM 29736, is now addressed as:
78-370 Highway 111
This address change affects the following building permits in process or issued
by the. City of La Quinta Building & Safety Department:
04-3803
04-6175
05-68 05-195
04-6013
04-680Y9
05-113 05-258
04-6165
04-7122
05-196
It should also be noted that this parcel, along with assessor's parcels -049, -050
and -051, was part of Parcel Merger 2004-457, recorded on 4/30/04 by the
Riverside County Recorder as instrument number 2004-0319136. It is anticipated
that a new parcel number will be generated by the Riverside County Assessor's
Office in the near future.
Please note this change and contact me directly at (760) 777-7084 if I may be of
further assistance.
Sincerely,
Kay Hensel
Office Assistant
I
j �"
4
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504
(760) 777-7012
OF- � 78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA_;CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 '
v
BUILDING PERMIT
Application Number
[04.00006013 Date 8/24/04
Property Address:.��:., �'
78380 HIGHWAY 111 STE 180
APN:
604-050-048- - -
Application description
REMODEL - COMMERCIAL
Property Zoning . . .
. . . COMMUNITY COMMERCIAL
Application -valuation
50000
Owner------------------
_
'r
Contractor
--------------
MADISON PTM LA QUINTA
PRIMUS CONTRACTING GROUP, INC
71361 SAN GORGONIO RD
1409 SO. 600 WEST, SUITE D
RANCHO MIRAGE CA
92270 BOUNTIFUL UT 84010
WCC: STATE FUND
WC: 17051812003 10/01/04
CSLB: 814726 11/30/04
CCC: B
------ Structure Information COMMERCIAL REMODEL -----
Construction Type . . .
. . TYPE V - NON RATED
Occupancy Type . . . .
. .. BUSINESS <50
Other struct info . . .
. . CODE EDITION 2001
FIRE SPRINKLERS YES
OCCUPANT LOAD 49.00
-FIRST FLOOR SQ FTG 1474.00
----------------------------------
Permit . . . . . BUILDING
-----------------------------------------
:� PERMI-,T,,
Addition 1
a desc
Permit Fee . . .
414.50 Plan Check Fee 269.43
Issue Date . . . ..
' Valuation 50'0.00
Qty Unit Charge
Per Extension
BASE FEE 252.00
25.00 - 6.5000 THOU BLDG 25,001-50,.000 .162.50
----------'------------------------------------------------------------------
Permit . . . . . . ELECT
- ADD/ALT/REM
Additional desc . .
Permit Fee
44.48 Plan Check Fe,e. 11.12
Issue Date . . . .
.Qty Unit Charge
Valuat Pori . 7"�-�J 0
Per"'1°"
9
Extension
`S�
.BASE FEE 2004 15.00
.0200_------ELEC
GARAGE NON- RE'SjffiNTIAL 29.48
'LMY
-----1474_00
---------- -----
-OR-
---------- OFl�o,rnp`_y=------------
Permit . . . .. . . MECHANICAL
ri �if4de0EpT ]4
t ..
or
P.O. BOX 1504
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Date: 9// S7494/
Archit or Engyneer:
f'r f (l✓KS i L
Archite t or ngineer's Ad�f ess:& 11
Phe wt
Lic. No.: - / 92/ O
t3UILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and myLicense is(5full force and effect. Q/
LicenseClass
se No. C/
Date ` V Contractor
OWNE -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
U I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work
himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale: If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.).
U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. , BA P.C. for this reason
Date
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
.,�G� A compensation insurance carrier d oy'ey b ar
Carrier%' iIf� Policy Number 1 i / `, O
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California and agree th if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
fo�CbXYApplica
it comply with th provis ns.
Date t
WARNING: FA LURE TO SECURE O ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct, I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this co to enter u e above -me ned property for inspection purposes.
Date ! / v Sighature (Applicant or Age ):
" � f •t+lYE r ? <:, t `� . � TI . ��t� � jt't Y'q6. ';y.
41� � ' • � F"� * ! Al � 4 `.
Page 2
Application Number . . . . . 04-00006013 Date 8/24/04
Additional desc
Permit Fee . . . . 39.50 Plan Check Fee 9.88
Issue Date Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 9.0000 EA MECH FURNACE <=100K 9.00
1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00
1.0.0 6.5000 EA MECH VENT FAN 6.50
----------------------------------------------------------------------------
Permit . . . . . PLUMBING
Additional desc
Permit Fee, 91.50 Plan Check Fee 22.88
Issue Date Valuation . . . . 0
Qty Unit Charge Per Extension
.BASE FEE 15.00
11.00 6.0000 EA PLB FIXTURE 66.00
1.00 7.5000 EA PLB WATER HEATER/VENT 7.50
1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00
----------------------------------------------------------------------------
Special Notes and Comments,
Commercial Remodel - REA DAY SPA Salon
TI, 1474 sqft, Type VN Sprinkled, "B"
Occupancy, Occupant Load 49.
------------------------------------'----------------------------------------
Other Fees . . . . STRONG MOTION (SMI) - COM 10.50
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 589.98 .00 .00 589.98
Plan Check Total 313.31 .00 .00 313.31
Other Fee Total 10.50 .00 .00' 10.50
Grand Total 913.79 .00 .00 913.79
Craig Anthony
Fire Chief
Proudly serving the
Unincorporated
Areas of Riverside
County and the
Cities of-
Banning
fBanning
Beaumont
Calimesa
Canyon Lake
4.
Coachella
..
Desert Hot Springs
4.
Indian Wells
e. -
Indio
Lake Elsinore
La Quinta
Moreno Valley
4.
Palm Desert
Perris
Rancho Mirage
San Jacinto
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione,
District 2
Jim Venable,
District 3
Roy Wilson,
District 4
Marion Ashley,
District 5
RIVERSIDE COUNTY FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
210 West San Jacinto Avenue • Perris, California 92570 • (909) 940-6900 • Fax (909) 940-6910
August 1, 2004
To: City of La Quinta 43
Building Department 7
Re: _ Release for Building Permits
REA Day Spa LAQ-04-TI-108
The Riverside County Fire Department hereby releases the above referenced project for
issuance of a building permit at the discretion of the Building Department.
Respectfully,
Dale A. Evenson
Fire Safety Specialist
H V EAGENERAMFORMSO ft Pwd Release - LO.doe
EMERGENCY SERVICES DMSION • PLANNING SECTION . INDIO OFFICE
82-675 Highway 111, 2"d FI., Indio, CA 92201 • (760) 863-8886 . Fax (760) 863-7072
I,
DEPARTMENT
Craig E. Anthony
Fire Chief
Proudly serving the
unincorporated
areas of Riverside
County and the
Cities of:
Banning
Beaumont
Calimesa
4;.
Canyon Lake
4.
Coachella
Desert Hot Springs
Indian Wells
Indio
4;.
Lake Elsinore
4;.
La Quinta
4.
Moreno Valley
Palm Desert
Penis
4;..
Rancho Mirage
San Jacinto
4.
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione,
District 2
Jeff Stone,
District 3
Roy Wilson,
District 4
Marion Ashley,
District 5
RIVERSIDE COUNTY
FIRE DEPARTMENT
HignWay 111, 2nd Ff., Indio.863-7072
January 26, 2005
Prest, Vuksic, Architects, Inc.
44-530 San Pablo Ave, Ste. 200
Palm Desert, CA 92260
Re: Non -Structural Building T/I Plan -Review„
LAQ-OS-TI-009 / i(%W Hwy --1 1-17' Ste 1.80--
A__<570
Fire Department personnel have reviewed and approved the plans you submitted for the above
referenced project. Please be advised the following conditions apply as a part of the conditions for the
issuance of a building permit.
1) Fire sprinkler system plans for the tenant improvement area must be submitted to the Fire
Department for review, along with a plan/inspection fee. The approved plans, with Fire Department
Job card must be at the job site for all inspections.
2) Provide keys to the tenant space for inclusion in the main building Knox Box. Key(s) shall have
durable and legible tags affixed for identification of the correlating tenant space.
3) Install portable fire extinguishers per Title 19, but not less than 2A1 OBC in rating. Contact certified
extinguisher company for proper placement of equipment.
4) Approved building address shall be placed in such a position as to be plainly visible and legible from
the street and rear access if applicable. In multi -tenant buildings, businesses shall post the
business name and suite number on back doors as well as the front. Suite numbers or letters must
be a minimum of 6" in height. All addressing must be legible and of a contrasting color with the
background.
Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy.
Requests for inspections are to be made at least 72 hours in advance and may be arranged by calling
(760) 863-8886.
All questions regarding the meaning of these conditions should be referred to the Fire Department
Planning & Engineering staff at (760) 863-8886.
Sincerely,
FRANK KAWASAKI
Chief Fire Department Planner
By
Walter Brandes
Fire Safety Specialist
Cc: City of La Quinta — Building Dept.
HAPEMP Data%U Quhda%PR0JECrS1T11tAa05.T).=.doe
EMERGENCY SERVICES DIVISION • PLANNING SECTION 4 INDIO OFFICE
82-675 Highway 111, 2nd FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072
-cp,
v,3 _
pai�ivta`Q,.�
1•- 9 Certificate of Occupancys
r
'J
�-ACAtP'DAATFD
ppb
k
OF Building & Safety Department
This Certificate is issued pursuant to the. requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was in compliance with the
a
provisions of the Building Code and the various ordinances of the City regulating building
=k,
construction and/or use,
u Y k
r
BUILDING ADDRESS: 78-370 Highway 111 Suite 180
r 3
# t4
Use classification: Commercial Remodel "REA Day Spa" TI Building Permit No.: 04-6013
{
! ri:
Occupancy Group: B Type of Construction: VN Sprinkled Land Use Zone: CR
�i
Owner of Building: Madison PTM La Quinta Address: 71361 San Gorgonio Rd
t
City, ST, ZIP: Rancho Mirage; CA 92270
I
By: Daniel P. Crawford Jr.
Date: 8/12/05
t
Building. Official
POST IN A CONSPICUOUS PLACE
-cp,
v,3 _